New developments in non-invasive coronary imaging

Coronary artery disease, and especially ischemic heart disease, is a major concern in Western society. To reduce mortality and morbidity early detection and treatment is important. Ideally, early detection should be non-invasive, fast and cheap. Coronary angiography (CAG) is a reliable technique to identify the coronary lumen. The ability of performing percutaneous transluminal coronary angioplasty and intra-coronary stent implantation has made CAG an indispensable procedure in the routine clinical setting. CAG, therfore, is seen as the gold standard to which other new modalities have to be compared to. CAG, however, is invasive and therefore carries the risk of morbidity and mortality. It also lacks the ability to visualize the vessel wall and can thus not detect the early stages of coronary artery disease. In the late 1970s, the first attempts were made to visualize the human coronary arteries non-invasively. With the rapid technological improvements of multi-detector computed tomography (MDCT) the accuracy of non-invasive coronary angiography has made progress.